Dilettantes always know more than experts. If you don't believe me, just ask one.
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I always joke with my doctors about how miserable their jobs must be these days with everyone going online and being convinced that they absolutely must have a disease that has been extinct for hundreds of years. Doctors like educated patients but not know-it-alls.
The lack of trust in experts and appreciation of intellect and knowledge is scary. I was raised in a world where academic achievement and intellectualism was the goal. Admittedly, some of those people could be a bit smug about their accomplishments, but I usually still tend to defer to an expert when seeking answers. Others seem to feel differently. And it is surprising that more of them don't pay a bigger price for their attitudes.
Many of them do - that price being missing out on an effective treatment and best outcome. Often one group of patients we aren't able to help are those who show up to the appointment every time telling us what to diagnose and what to prescribe. And they refuse to listen to anything else. It's fine and even encouraged to ask these questions. But there is definitely a percentage who think they know more than an expert who has spent years of intense training, earned rigorous board-certification for competence, and seen thousands of cases. They refuse to consider our recommendations, because they already know better from somewhere on the internet.
In some cases, when these folks refuse to consider our recommendation, we're actually trained to just do what they want first if it's reasonable enough, because if we don't, the better treatment choice will be thwarted by a Nocebo effect. They'll try it one day and say they knew it wasn't going to work or would have side effects, and then list it as a failed treatment. But if you let them try their preference (as long as it's still within standard of care and reasonable), sometimes when it doesn't work you can get them to listen to maybe trying your recommendation and giving it a fair trial. But some never listen, because I guess they've earned some expertise on facebook. And they do tell me they read it from people on facebook who know.
Obviously it depends on what they want. I never diagnose something that isn't accurate or prescribe a controlled substance when it's not truly indicated. Some of them I never prescribe period. But when there are multiple reasonable options, I can promise you that best outcomes come from listening to the doctor and doing what they would recommend the first time.
It can make it tough or impossible, sometimes with the pseudo-know-it-alls, you could not be more right.
Among Americans who have been fully vaccinated, the CDC has identified about 5800 break-through cases of Covid 19 per the Wall Street Journal. Sounds like a lot, right? Not really. That is out of more than 66 million Americans fully vaccinated. Based on this data, the rate of breakthrough infection after full vaccination is 0.008%. Pretty good odds for a poker playing pie bettor like me.
Of the 5800 break-through cases, a smaller percentage needed hospitalization - 396 people. And 74 people died.
Millions of people are immunocompromised, and so some of those people just don't produce antibodies against Coronavirus, even with full vaccination.
But as much as could have been hoped, these vaccines work, and do they ever.
https://www.wsj.com/articles/cdc-ide...ts-11618490232
Too bad there is no vaccine for stupidity.
While I agree with your conclusion, I've got to imagine 5800 is a severe undercount. Given the amazingness of the vaccine to reduce severity of COVID, many may choose to simply rest a bit more at home or actually have asymptomatic COVID completely. Not trying to diminish the numbers because the key thing is making hospitalizations and deaths basically not occur, but if every person who has been vaccinated got regular COVID tests, it would surely be several times more than 5800. Still, it is undoubtedly true that the "real world" results from those vaccinated is truly promising.
Yes, 100% agree. The vaccines work but I honestly don’t know what we can make of the absolute number of breakthrough infections at this point. This is a snapshot of breakthrough infections just a few months after the first vaccine doses were administered and much less time since shots were given in large numbers.
I remember a conversation with a friend last summer who said something like, “less than 1 tenth of 1% of the US population has died from COVID-19. This is a huge overreaction.” Looking at the absolute number of breakthrough cases at this point strikes me as a similar error in the opposite direction.
Second. I am 100% in favor of 100% vaccinations but these numbers asserted are just not plausible. If you know 2 people who have contracted covid following vaccination it puts the lie to the assertion. Vaccines are great. No need to gild the lilly and reduce confidence in the message that we would all be better off with vaccines in our arms.
OK, just to make sure I am understanding you - are you suggesting that a healthy woman between 18 and 49 would be better off not getting vaccinated at all? Or just refusing J&J? Cause if you are suggesting that a healthy woman between the ages of 18 and 49 would be better off not getting vaccinated at all, I will again say no, she is taking a much bigger risk, even with masking and distancing, by remaining unvaccinated. Masking and distancing are nowhere near as effective as vaccination at preventing the worst possible outcomes. Plus, we keep finding new more contagious variants. So, if someone chooses to never leave their house, perhaps . . . nah, that's not healthy choice long term for anybody, even if it prevents covid.
If you are suggesting that a healthy woman between the ages of 18 and 49 should choose Pfizer of Moderna over J&J, sure, do that. As long as J&J is paused, the choice is made for us anyway.
I am suggesting something very narrow and straightforward: a thirty year old woman in the US who is able to mask and distance might be better off waiting for a safer vaccine to become available than to get the J&J vaccine and take a small chance of having a dangerous clotting issue that can’t easily be treated if it happens.
Of course, as you say, that is a choice that no one in the US has to make right now.
I attended a memorial service for a friend's sister who died of cancer in December. The priest decided to let everyone in to the service so there were 200-300 people (of course that was before any vaccine). I stayed for no more than 10 minutes, afraid I was knee deep in a super spreader event, but spent a few minutes hugging and consoling my friend and his family. Two weeks later my friend contacted me because he and his whole family had coronavirus. Luckily I did not contract it, and I attribute that to the fact that I stayed only a few minutes, but I'm sure there were others in the service who did.
IMHO, screw the brouhaha and do what you and your wife feel is right. There is no reason to unnecessarily mess around with this thing if you don't need to and the virtual option is a perfectly acceptable alternative.
Not surprisingly, the CDC is working on revised guidelines for vaccinated folks: https://talkingpointsmemo.com/news/w...lly-vaccinated
NC being set free, sort of. Governor hopes to lift all restrictions, except masks, by June 1.
https://abc11.com/politics/cooper-ex...ne-1/10534505/
Thanks for the article. I find it interesting that Gov Cooper stated an actual threshold for when he would lift the mask requirement of 65% of adults having at least one dose. There can be debate around whether that is a good number or not. Personally, I think 65% is a fair number to be in the neighborhood of herd immunity/decreased transmission. Balancing that some unvaccinated people have some immunity from having COVID with the fact that children can't get vaccinated yet (although I hope 12-15 can start getting shots before then).
Whatever that number might be - my larger point is what do people think about having a % vaccinated number to shoot for in terms of encouraging the hesitant to get vaccinated? One of the reasons that I have heard from the hesitant is that this pandemic will never end, why should I bother getting a vaccine. While I don't think this a valid argument I can understand it from the POV that when something seems like it is never going to end you feel powerless to stop it. If we draw a line in the sand and say we lift mask restrictions when we hit XX% vaccinated to you think it would lead to more people getting vaccinated?
I know it won't matter to some people, but we don't need everybody. We are currently at 51.5% nationwide with 1 shot for 18+ (NC is at 47.1%). Do you think having a goal (versus not having a goal) would help get that 15% more that we need over the next 6 weeks?
I don’t think much of anything that has a rational basis will be effective in convincing any meaningful amount of the holdouts. Trying to be diplomatic here.
We’re all gonna die eventually, so why bother living?